September 30, 2022

Life after lung transplant

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Learn more about what to expect during the lung transplant recovery process in the months and years after undergoing this surgery.

If you’re a candidate for a lung transplant because of advanced lung disease that’s impacting your quality of life, you may be wondering what the lung transplant recovery period entails and what to expect going forward after the procedure.

“The reason we do lung transplant is because we think that we can improve survival for a lot of our patients,” said Dr. David Erasmus, medical director of the Vanderbilt Lung Transplant Program. “For others, we can improve their quality of life. And in some patients, we can improve both.”

Lung transplant outcomes

As a lung transplant candidate, you’re likely battling a lung condition that significantly impacts your daily life and prevents you from engaging in many day-to-day activities as well as the things you enjoy. A lung transplant may be able to change all of that.

“Most of the patients we transplant require oxygen therapy with quite a debilitating lifestyle by the time they get to us,” Erasmus explained. “Patients after lung transplant can expect to be free from that burden, with lung function that would be significantly improved. And they’re able to do things they haven’t been able to do for a long time.”

Overall, the average life expectancy after lung transplant is six to six and a half years. “But there are patients who may live much longer than that,” Erasmus said. “And there are patients who may be quite ill and won’t live that long.”

Erasmus added that if a patient gets through their first year without any significant organ rejection, then one can look at a much longer survival — seven to nine years or more. By contrast, many patients who are candidates for lung transplant are expected to survive two years or less without the procedure.

“To see these patients not only off oxygen but thriving several years afterward is a very fulfilling part of what we do,” Erasmus said.

Hospital recovery period

Your first few days after surgery will be spent in the intensive care unit, Erasmus said. Eventually, you’ll be transferred to a regular hospital room, where you will likely spend about two to three weeks. The timeframe depends on each patient’s unique circumstances.

Initially, you will have chest tubes that will drain fluid, but the surgical team will remove those when the time is right. Shortly after chest tube removal, you’ll be discharged from the hospital if your recovery is going well. While in the hospital, you’ll begin physical rehabilitation, which will be continued after discharge.

Lung transplant recovery in the first three months post-op

In the first three months post-op, you’ll need to stay locally so that you’re close to your care team. “It is the time when patients are most vulnerable to infections, rejections and other complications,” Erasmus explained. “So we like our patients to stay close by.” During this time, you’ll undergo frequent bronchoscopies, likely weekly in the first month to monitor for any concerns. Thereafter, you’ll switch to monthly bronchoscopies in the first three months.

You’ll also be taking medications that suppress your immune system to prevent organ rejection. That medication regimen may need to be adjusted to your body’s particular needs as time goes on after the procedure, he added.

Additionally, you’ll start an outpatient pulmonary rehab program. “Many patients will have lost a lot of muscle strength going into transplant because of their limitations from their lung disease,” Erasmus explained. “Their lung function will get better over time, but one needs to work on the entire body to recover properly.”

Recovery after three months and beyond

Once those three months have passed and you’ve successfully completed rehab and your lungs have healed, Erasmus said, you’ll be able to return to your home if you live elsewhere. However, you’ll continue to have monthly follow-up visits with your care team throughout that first year. After that, follow-up visits will occur every three to four months. You will be scheduled for periodic bronchoscopies as well, to assess the airways and make sure there is no rejection or infection. Once you reach the two-year mark, these bronchoscopies will be scheduled only as needed.

You will continue to be seen in the clinic every three to four months, or more frequently if needed. You will also have to have blood drawn periodically to check levels of medications and to help assess bodily function.

In addition to complying with your physician’s recommendations on follow-up visits and medications, you’ll also need to take certain precautions going forward after lung transplant. Being on immunosuppressive medications can make you more vulnerable to infection, so you’ll need to take precautions to avoid getting sick. Examples include avoiding the consumption of raw or undercooked meat and being compliant with recommended vaccinations. Your transplant team will go over these precautions in detail with you. But Dr. Erasmus said they may involve some lifestyle changes, which are specific to each person and individual needs.

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Vanderbilt Health has one of the oldest lung transplant programs in the country – and the only one in Tennessee, giving new hope and longer life to patients suffering from end-stage lung disease.

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